mistyPA Posted August 14, 2011 Share Posted August 14, 2011 I really don't mean to start any trouble with this post, but I have to ask the question...Why is it that there is so much misrepresentation about PA vs NP? Why is it that when my NP colleague was taking her board's she was asked to supply a reason for why an employer should employ a NP instead of a PA? Are NPs so insecure that they have to find reasons to defend themselves? There was very little, if anything, said about the difference of an NP or PA during my school years. Though my PA program prepared me well, there were a lot of faults with the program; however, there was never a comparison made between an NP and a PA. Now that I have been working as a PA, I cannot believe the constant comparisons. I will not apologize for the fact that PA education is more clinically focused and that PAs are simply better trained. My SP has both an NP and myself (PA) on staff and she has said more than once that I am clinically much more sound and will often leave the practice in my hands rather than the NP. Also, there is a lot of press about the fact that PAs cannot practice independently and that we can't prescribe narcotics. Now, I don't know what every state allows, but to the best of my understanding PA's can write for schedule II-VI drugs in most states. PA's can't practice independently, but from what I understand NPs need to at least have a collaborative agreement in place with a physician. Quite frankly, the rules in my state say that I must work under the supervision of the MD, but depending on the PAs relationship with the MD, it is often a collaborating agreement. At least that is how I work with my SP. I just don't think one profession should trash the other just to get ahead. Now, it could be said that I am doing that very thing by writing this post, but that's not true. I am simply very tired of hearing how it is so much better to become an NP over a PA based on statements that really aren't true. Thanks for allowing me to vent for a moment or two. Link to comment Share on other sites More sharing options...
Acebecker Posted August 14, 2011 Share Posted August 14, 2011 The issue doesn't seem to be so much one of quality - it is hard to argue that NPs come out better prepared than (or in most cases even as well prepared as) PAs even if the NP has had significant prior nursing experience. This is fairly well founded in everyone's experience and is almost a natural outcome of the way they are trained vs. how we are trained. That said, after 2-5 years of clinical practice, there is generally a completely equal footing between the two professions. However, the latest concern has been over legislative changes that have been creeping up on us for, apparently, decades that are making it easier for practices to employ NPs over PAs. In several states, the PA practice plan certification process has become onerous for our SPs such that they no longer want to have to do the extra leg work when they can hire an experienced NP with 1/2 the effort (and presumably a slightly lower pay rate). The crux of the issue is that the big guns (CMS to name one) has jumped more behind the NP bandwagon than the PA bandwagon and thus NPs have more direct billing privileges than PAs - PAs are relegated in some cases to billing "incident-to" the physician they work for which means more paperwork and, in some cases, a smaller piece of the pie for that physician's practice. In addition to these changes, there has been a lot of talk lately about the efficacy of the nursing lobby in bombarding Washington with requests for these reduced restrictions on NPs whereas we, as PAs, have not seen nearly so much activity from the AAPA - partly because the constituency is so much smaller (70,000 PAs nationally vs. all of the LPNs, RNs, and NPs in the nation) and partly because it seems the AAPA has not taken an aggressive approach for fear of physician backlash. The debate thus has lately raged that, because NPs have so many more "freedoms" than PAs do, it will benefit a new student to become a NP over PA for future ease of the practice of medicine. Me personally: I would rather exit school ready to practice medicine, no matter what the potential hassles will be in the future. My conscience is clear which matters more to me than having fewer headaches down the road. Hope that helps clarify. Andrew Link to comment Share on other sites More sharing options...
Guest TerryF Posted August 14, 2011 Share Posted August 14, 2011 The misunderstanding/quarrel is the reason we need to demand more from AAPA, or we should fire them all: ie, AAPA. TerryF Link to comment Share on other sites More sharing options...
Kaepora Posted August 15, 2011 Share Posted August 15, 2011 Me personally: I would rather exit school ready to practice medicine, no matter what the potential hassles will be in the future. My conscience is clear which matters more to me than having fewer headaches down the road. Alright, I might be splitting hairs here, but, why wouldn't you go to Medical school if your biggest concern is exiting school ready to practice medicine. Many, many physicians make this argument against PAs all the time. If you are concerned with being properly trained to the highest degree, then PA school shouldn't even be an option. Won't your conscience suffer? Now, I know I am playing devil's advocate here a little, but still. I would say PA and NP are a lot closer in clinical competency than are NP/PA and MD/DO. NP<<PA<<<<<<<<<<<MD/DO. Comparatively speaking, the clinical hours for MD/DO are astronomical compared to NP/PA but not so different when comparing NP to PA. I'm of the school of thought that all paths make for great providers when that provider fills the niche they were trained to fill. It just doesn't make sense for either NP or PA to put the other down because the differences are soooo small, plus, some of the reasoning may get you into sticky territory. A perfect example is the CRNA's fight against AAs. It very closely mimics the Anesthesiologist's argument against CRNAs... Link to comment Share on other sites More sharing options...
Kaepora Posted August 15, 2011 Share Posted August 15, 2011 And I agree with you Terry!! See, we can be friends on here! Link to comment Share on other sites More sharing options...
Acebecker Posted August 15, 2011 Share Posted August 15, 2011 Your point is granted the PAs/NPs are a far cry from MDs/DOs upon graduation. Excuse me for being unclear - What I left unsaid is that, for a 2.5 year degree, I wanted to be as well prepared as possible to practice medicine. Medical school for me is not an option, but I still wanted the best training I could get - and that has been PA school (and I would attest that it is the best training for every candidate seeking mid-level training even though it might not be the best fit for every candidate when taking into account prior medical experience and future plans). Hope that clarifies. And yes, my hairs are split. Andrew Link to comment Share on other sites More sharing options...
Kaepora Posted August 15, 2011 Share Posted August 15, 2011 Good. My, how I do love splitting hairs! Link to comment Share on other sites More sharing options...
dpc511 Posted August 16, 2011 Share Posted August 16, 2011 Yep, I hear the same comparisons made in my state (Tennessee). Interestingly, the practice guidelines for NPs and PAs here are pretty much identical. Both require physician supervision, meaning 20% monthly chart review. There is no such thing as an "independent" midlevel in Tennessee, though most people here believe NPs practice that way. Also, there is a lot of press about the fact that PAs cannot practice independently and that we can't prescribe narcotics. Now, I don't know what every state allows, but to the best of my understanding PA's can write for schedule II-VI drugs in most states. PA's can't practice independently, but from what I understand NPs need to at least have a collaborative agreement in place with a physician. Quite frankly, the rules in my state say that I must work under the supervision of the MD, but depending on the PAs relationship with the MD, it is often a collaborating agreement. At least that is how I work with my SP. Link to comment Share on other sites More sharing options...
Kaepora Posted August 16, 2011 Share Posted August 16, 2011 Well, I don't think that having NPs labeled as "mandatory providers" and PAs labeled as "optional providers" really helps the PA image in Tennessee... Link to comment Share on other sites More sharing options...
Contrarian Posted August 23, 2011 Share Posted August 23, 2011 Also... About 5 PA positions sprinkled in the 10 pages of NP jobs in the Aug 2011 issue of "Advance for NPs & PAs" ... Link to comment Share on other sites More sharing options...
brookspa Posted August 23, 2011 Share Posted August 23, 2011 saw that contraian...then again, i dont know anyone who ever accepted or sought a pos. from a want ad. Link to comment Share on other sites More sharing options...
medman2007 Posted August 23, 2011 Share Posted August 23, 2011 saw that contraian...then again, i dont know anyone who ever accepted or sought a pos. from a want ad. I agree. PA job postings in NC and Ga at least are few and far between (compared to "ads" for NPs), but all indications are that new PAs and experienced PAs are not having problems finding jobs. Similarly, appears that NPs not having trouble finding jobs either. It's the brand new RNs that are suffering. Link to comment Share on other sites More sharing options...
alleycat Posted August 30, 2011 Share Posted August 30, 2011 Andrew, I send condolences for your split hairs. do you require a split splint?? and I know I'm one PA who looked for work thru want ads....and found NPs requested far far far more than PAs. Yeah, I agree mostly that we're all on equal footing 2-5 yrs out, I've met a few who are <<< , as they say. however, nursing at all levels outnumber us 40 x 1 nationally, and financially/PAC <---Political Action Committee. and indeed AAPA seems not to take action (agree: ruffled doc feathers). However, In my experience and IMHOP, NPs get better ratings overall and PAs as substandard...and have been told that my SPs! "we have to have more supervision" "we have to test more often because we don't know as much as NP because we have NO medical experience prior to PA Program " "PAs do not belong in specialties...they're okay in primary care if properly supervised" ...this is what I hear. dang...now my dander is up. sorry....must gather dander and replace it. alleycat...done venting Link to comment Share on other sites More sharing options...
andersenpa Posted August 31, 2011 Share Posted August 31, 2011 Now, I don't know what every state allows, but to the best of my understanding PA's can write for schedule II-VI drugs in most states. PA's can't practice independently, but from what I understand NPs need to at least have a collaborative agreement in place with a physician. Quite frankly, the rules in my state say that I must work under the supervision of the MD, but depending on the PAs relationship with the MD, it is often a collaborating agreement. At least that is how I work with my SP. [/QUOTE] The Pearson Report summarizes NP scope for Rx and Dx/Tx. The summary chart is on pg 22 http://www.npwh.org/files/public/PEARSON.pdf Link to comment Share on other sites More sharing options...
medman2007 Posted August 31, 2011 Share Posted August 31, 2011 Andrew, I send condolences for your split hairs. do you require a split splint??<br>and I know I'm one PA who looked for work thru want ads....and found NPs requested far far far more than PAs. Yeah, I agree <strong><u><em>mostly </em></u></strong>that we're all on equal footing 2-5 yrs out, I've met a few who are <<< , as they say. however, nursing at all levels outnumber us 40 x 1 nationally, <u>and</u> financially/PAC <---Political Action Committee. and indeed AAPA seems not to take action (agree: ruffled doc feathers). However, In my experience and IMHOP, NPs get better ratings overall and PAs as substandard...and have been told that my SPs! "we have to have more supervision" "we have to test more often because we don't know as much as NP because we have NO medical experience prior to PA Program " "PAs do not belong in specialties...they're okay in primary care if properly supervised" ...this is what I hear. dang...now my dander is up. sorry....must gather dander and replace it. alleycat...done venting <br><br><br> Better overall ratings? what ratings? I'm a dual NP/PA and have been to many places around the country while working in clinical research, and I've never heard this. Not saying you haven't, but just wondering about the higher "ratings" of NP over PA? As a matter of fact, I've heard quite the opposite in many environments. If you're supervising physicians have actually stated the above to you regarding NPs having so much more clinical experience than PAs, you need to leave that position b/c they are idiots. Link to comment Share on other sites More sharing options...
alleycat Posted September 2, 2011 Share Posted September 2, 2011 I left that position last December, without look back. and it felt great. Link to comment Share on other sites More sharing options...
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